The life-saving potential of the prostate-specific antigen (PSA) blood test is demonstrated by a Cleveland Clinic prostate cancer study released last summer, according to Dr. David Samadi, robotic prostate surgeon and Vice Chairman, Department of Urology and Chief of Robotics and Minimally Invasive Surgery at New York's Mount Sinai Medical Center.
The study, published August 2012 in the journal Urology http://www.ncbi.nlm.nih.gov/pubmed/22857756, was designed to assess how the onset of routine PSA testing in the early 90s impacted long-term prostate cancer treatment outcomes. Data was reviewed from patients who underwent either prostate removal surgery or radiation for prostate cancer.
Researchers found an 82 percent 15-year metastasis-free survival rate in prostate cancer patients treated after routine PSA testing was implemented (1993-1996), compared with a 74 percent 10-year metastasis-free survival rate for patients treated before routine screenings (1986-1992).
Dr. Samadi said, "Men with prostate cancer are living longer and with excellent recovery odds. Early diagnosis a major factor in our success with this disease."
The Cleveland Clinic researchers compared data from more than 1,700 prostate cancer patients. The men were divided into groups of those treated in the years before PSA testing was routinely recommended for men and in the years after. The cases represented a range of low-, intermediate-, and high-risk disease progression and the benefit from PSA testing was present across all disease levels.
Despite the positive indications found in similar studies comparing pre- and post-PSA data, many men are undecided about whether or not to screen. In May 2012, the U.S. Preventive Services Task Force recommended against PSA-based screening for men regardless of age (not including surveillance after diagnosis or treatment of prostrate cancer). The American Cancer Society recommends that men considering prostate cancer screening make informed decisions based on available information, discussion with their doctor, and their own views on the side effects of screening and treatment.
Prostate cancer experts remain divided on the topic of screening. "Early diagnosis opens a valuable window for treatment, but it's important for men to understand that the PSA is not a one-time test. There's no positive-or-negative when it comes to prostate cancer," explains Dr. Samadi. "We monitor PSA results, over a period of years, to identify when a man's level may be elevated so that we can explore further and, if warranted, address the cancer via robotic prostate removal or other means of treatment."
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